Publication:

Prevalence of microalbuminuria in patients with essential hypertension and its correlation with retinopathy and carotid artery intimal-medial wall thickness

Background Hypertension affects wide range of organs, eventually resulting in events like heart failure, chronic kidney disease, stroke and blindness. However, there are only subtle changes present initially, like microalbuminuria (MA), elevated CCIMT and retinopathy, in patients with uncontrolled hypertension. Patients with microalbuminuria are postulated to have significantly high risk of TOD and this study aims to explore this association. The primary objective of this study was to explore prevalence of MA in patients of essential hypertension and ascertain its correlation with elevated CCIMT and retinopathy.

Methods A cross-sectional study was done on 250 patients of essential hypertension, designated as per JNC8 guidelines. Patients of diabetes (Type I/II), thyroid disorders, CKD, UTI, obesity (BMI>30 kg/m2), cataract and those with history of stroke, were excluded from this study. A statistical analysis was performed and relationship between microalbuminuria and TOD evaluated.

Results Significant prevalence of TOD was seen, namely, microalbuminuria in 44.8%, retinopathy in 56.8% and elevated CCIMT in 35.6% patients. Significant association could also be appreciated in hypertensive patients with microalbuminuria when compared to those without, with respect to the presence of other TOD, specifically, retinopathy (OR 6.21, 95% CI, p-value<0.001) and elevated CCIMT (OR 26.5 95% CI, p value<0.001).

Conclusions Given the high prevalence and significant association, it was concluded that microalbuminuria could function as a great tool to identify possibility of other on-going target organ damage and initiate timely treatment, to prevent the occurrence of catastrophic events in the future.